Fidelity to the EBDP Programs in Michigan: Findings of Evaluation - - PowerPoint PPT Presentation

Joan Ilardo, PhD, LMSW Assistant Professor, Director of Research Training. Core Faculty-Geriatric Education Center of Michigan

Fidelity to the EBDP Programs in Michigan: Findings of Evaluation Report

APPENDIX F3

• Determine degree to which

sample of PATH leaders adhere to PATH curriculum

Purpose of PATH Fidelity Assessment

– Completed PATH leader training – Co-led PATH workshop – Conducted PATH leader and master trainer

• nline survey in winter 2010-2011 (118

responses) – Conducted 6 key informant interviews of PATH coordinators, master trainers and T-trainers – Conducted 3 site observations (sessions 2 and 5)

Study Design: Addressed 5 Questions

• How are PATH leaders reflecting on

what occurs in sessions they conduct? Do they conduct peer or self evaluations?

Evaluation Question 1

• 2/3 of PATH Leaders used recommended

self-evaluation form after conducting workshop.

• 86% talk with co-leaders after each session

to discuss how it went

• Another 11% have a discussion at end of

workshop series

• Only 3% reported they never discussed how

things went at PATH sessions.

Evaluation Question Results

• What are the PATH

leaders’ perceptions of the leader training?

Evaluation Question 2

• Felt trainers did well explaining PATH was an

evidence-based curriculum based on Stanford Chronic Disease Self-Management Program

• Aware of research showing positive results for

participants who apply what they learn.

• 93% reported master trainers did very well

emphasizing importance of “sticking to the book”.

• All interviewees were emphatic that curriculum is

closely followed.

Evaluation Question 2 Results

• Are there ways PATH

leader support could be enhanced to increase fidelity?

Evaluation Question 3

• Different versions of the leader manual
• Guided imagery -Session 5, what to do if

a participant does not want to do the activity

• Action Planning

– How to do them? – Writing them down?

• No consensus on leaders doing self-

evaluations

Evaluation Question 3 Results

• What are the strengths

and challenges encountered by PATH leaders as they conduct classes?

Evaluation Question 4

• Strengths

– Understand concept of fidelity and work to impart that in leader training – Recruit leaders who are familiar with PATH and see how program can benefit participants – Very conscious about sticking to book and did excellent job – Stayed on topic – Set good boundaries while being approachable – Strong role models: engaged, positive, respectful, caring

Evaluation Question 4 Results

Challenges Noted by respondents

• Participants’ literacy levels
• Frail, elderly groups
• Quiet groups
• Chatty groups
• Diverse groups
• Dominating individuals
• Self-interested individuals

Evaluation Question 4 Results

Challenges Observed

• Positive thinking activity
• Writing letter to provider
• Buddy call

Evaluation Question 4 Results

• What ways can data

gathered by OSA and MDCH be used to monitor PATH fidelity?

Evaluation Question 5

• All coordinators review information on MI PATH

forms before sending them in

• Use data from MDCH for

– Reports to agencies – Recruiting participants – Presentations to medical groups – Publicity – Feedback for PATH leaders

• No system in place to track outcomes but would

welcome the information

Evaluation Question 5 Results

• Guidance from MDCH about resources available at PATH

workshops

• Recruit lay leaders who have chronic conditions since participants

identify with them.

• To increase fidelity, all leaders should role model dealing with difficult

emotions in Session 2.

• Booster sessions should be developed by MDCH and OSA that

reinforce best practices for the action plan and problem-solving activities.

• Session 5 closing activity is difficult because of the various strategies
• ffered to participants. Clarification could be provided through the

booster session.

• Session 5 Positive Thinking activity can be confusing. Stanford could

be approached about alternative ways to practice this concept such as role modeling by co-leaders.

Recommendations

• Systems for connecting leaders who prefer to work together could

increase leader retention and satisfaction.

• Coordinator should be trained about how to develop/nurture

relationships with primary care oriented-organizations to reinforce the benefits of PATH for patients with chronic diseases and ways to encourage patients to attend.

• One way to engage physicians is to offer to conduct behavior change

follow-up surveys for their patients who attend PATH workshops. Follow-up surveys could be conducted at 6 and 12 months.

• Develop relationships with residency and fellowship to include

evidence-based self-management programs as part of their community resources segment of fellowship training.

• Consider using a Facebook page as an additional way to promote MI
• PATH. The official MI PATH website link could be part of the page.

Recommendations